Polymyalgia Rheumatica.
Last updated Thursday, February 10, 2005
Giant cell arteritisWhat is giant cell arteritis? Giant cell arteritis, or GCA, is a condition in which certain arteries (blood vessels) in the body become inflamed.
Symptoms of GCA
The symptoms of giant cell arteritis include:
- pain in the jaw muscles when eating or talking
- severe headaches
- loss
of vision, blurry vision or double vision--the vision loss often is
described as having a curtain pulled partly over one's eye
- tenderness of the scalp or temples
- difficulty hearing
- persistent sore throat or difficulty swallowing
Loss of vision can be temporary or permanent and is the reason why
higher doses of prednisone is needed. If you have PMR and start having
vision problems, call your doctor immediately. Also tell your doctor if
you develop any of the other symptoms. It is important to diagnose and
treat giant cell arteritis early to prevent blindness. GCA incidence and risk factors GCA can develop in some people with PMR. These two diseases often
occur together. About 10-15 percent of people with PMR also have GCA.
However, GCA can occur on its own without PMR. Almost 40 percent of people with GCA also have PMR. Prognosis Both PMR and giant cell arteritis usually will last one to two
years. How long these conditions will stay in an individual case can
vary quite a bit. Sometimes these diseases recur even if you have been
doing well for some time.
Treatment allows most people with these diseases to lead active and
productive lives. Most people are able to take lower doses of the
medication after they have been treated for a while. Many people
eventually are able to stop taking the medication after one or two
years, but the threat of relapse requires close communication between you and your doctor. Gentle exercise and prevention of osteoporosis are even more important in people under treatment for giant cell arteritis due to the higher doses of corticosteroids needed. Causes of GCA As with PMR, the cause of GCA is unknown. Giant cell arteritis usually
affects areas near the temples on the upper front sides of the head. It
also involves other arteries in the head, neck, arms, and,
occasionally, will affect other arteries in the body. Inflammation
causes the artery to become narrow or blocked. Inflammation can cause
problems because too little blood is getting through the blood vessels.Diagnosis of GCA Your doctor may need to remove a small piece of an artery above and in
front of your ear to determine if you have giant cell arteritis. Often
the artery will be taken from the temple through a small incision. You
will not need to be put to sleep to do this, but you will receive
medicine to numb the area. The piece of the artery then will be
examined under a microscope. If you have giant cell arteritis, the
artery will be inflamed. A sed rate reading also can help determine the
diagnosis because, as in the case of PMR, the sed rate is almost always
higher than normal.Treatment of GCA Corticosteroid drugs
are used to treat giant cell arteritis. Higher doses are required to
treat giant cell arteritis than to treat PMR. The usual dose of
prednisone for giant cell arteritis is 30-60 mg per day. Other
medications are available if side effects from the corticosteroids
become a problem. You can expect to stay on this treatment for many
months to several years, but the dose will be lowered over time once
symptoms are controlled.
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